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must <br /> Burnett County Subdivision Permit Application Fees o, ,may:$50.00 <br /> Survey of l: S50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision iSurvey:g `s20o.00 $50.0 /lot <br /> Owner: Alice B Sholler Trust fir: Kelly Mackereth c <br /> 4101 Zenith Ave S m <br /> Address: Address: .* <br /> 715 SW 51st Terrace <br /> A 2. <br /> Minnea Minneapolis MN 55410 Cape Coral FL 33914 <br /> °O i <br /> Phone: Phone: <br /> Original Parcel Information <br /> 07-012-2-40-15-25-5 05-001-014000&015000 <br /> Tax ID#: Section__25 Township 40N Range 15W <br /> Original Description(or attach copy): Lot 1 &2 CSM V1 P242 GL 1 <br /> i <br /> a <br /> A <br /> n <br /> Current Zoning: RR1 Floodplain Y/N: Y Wetlands Y/N: Y Lake/River Class: <br /> Name of Water Body: Sand Lake!Pine Lake Shoreland Agreement/SIPS YIN: <br /> Farmland Preservation YIN: N Managed Forestry Law Y/N: N <br /> 1 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: r' <br /> Acres <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> V <br /> Proposed access to public road: h <br /> C <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: Jt <br /> 6— <br /> j�,�er.."-Say w <br /> * 8;? <br /> rtlit <br /> n <br /> ➢ Does parcel meet Zoning Requirements? Yes No Fee Rec: /DQ. <br /> a Check#: eoOs'38 <br /> A Does parcel require a Survey? Yes No ff <br /> Reconciles with Real Property Lister 411010 No Date: /1( .O2J) <br /> If not,explain: <br /> Applicatio Approved enied Reason for Denial- <br /> Land U Date: <br /> /� ZoZ3 <br /> ii <br />